RESUMO
OBJECTIVE: To analyze histological features of esophageal strictures in children with chemical burn following ingestion of household products containing sodium (potassium) hypochlorite, sodium (potassium) hydroxide. MATERIAL AND METHODS: We analyzed 3 children with complicated caustic esophageal burns. Children at the time of swallowing the caustic were 26.3±4.1 months. Multiple dilatations of esophageal stricture were ineffective. Therefore, extirpation or subtotal resection of the esophagus and esophagocoloplasty were performed. We stained specimens using hematoxylin and eosin, as well as Masson's trichrome. RESULTS: Severe esophageal burns caused by sodium (potassium) hydroxide and/or sodium hypochlorite are followed by irreversible tissue lesions and non-dilatable stricture. Strictures are localized in the areas of physiological narrowing of the esophagus. The longest stricture follows ingestion of liquid substance. Histological properties include atrophy of glands and mucous membrane, muscle layer substitution by connective tissue and diffuse sclerosis of esophageal wall. CONCLUSION: Non-dilatable esophageal stricture following caustic burn in children is due to irreversible morphological lesion of esophageal wall with mucous layer atrophy and sclerosis of all layers.
Assuntos
Queimaduras Químicas , Cáusticos , Estenose Esofágica , Criança , Humanos , Estenose Esofágica/induzido quimicamente , Estenose Esofágica/diagnóstico , Cáusticos/toxicidade , Constrição Patológica/complicações , Queimaduras Químicas/complicações , Queimaduras Químicas/diagnóstico , Queimaduras Químicas/cirurgia , Esclerose/complicações , Hidróxidos , Atrofia/complicações , Potássio , SódioRESUMO
The authors present ultrasonography-assisted endoscopic diagnosis of chemical burn of the esophagus. This method early predicted decompensated cicatricial stenosis of the esophagus that was valuable to determine treatment strategy. Preventive mini-invasive endoscopic percutaneous gastrostomy provided adequate enteral nutrition in a patient with decompensated esophageal stenosis before reconstructive surgery.
Assuntos
Queimaduras Químicas , Queimaduras , Estenose Esofágica , Humanos , Queimaduras Químicas/complicações , Queimaduras Químicas/diagnóstico , Endossonografia , Estenose Esofágica/diagnóstico por imagem , Estenose Esofágica/etiologia , GastrostomiaRESUMO
Perforation of the esophagus is a serious and dangerous condition due to progressive development of mediastinitis and sepsis. This disease is often fatal. In the last decade, endoscopic stenting of the esophagus became more common in these patients as an alternative to traditional surgery. We report successful minimally invasive endoscopic treatment of esophageal perforation with post-burn necrosis of its wall.
Assuntos
Perfuração Esofágica , Esofagoscopia , Mediastinite , Implantação de Prótese/métodos , Drenagem , Perfuração Esofágica/diagnóstico , Perfuração Esofágica/etiologia , Perfuração Esofágica/cirurgia , Humanos , Mediastinite/diagnóstico , Mediastinite/etiologia , Mediastinite/cirurgia , Sepse/etiologia , StentsRESUMO
AIM: To analyze patients with chemical burn of esophagus followed by cancer. MATERIAL AND METHODS: Since 2010 till 2017 esophageal cancer has been diagnosed in 4 patients with esophageal cicatrical stenosis after previous chemical burn. Cervical segment of the esophagus was involved in 1 case. RESULTS: Resectable tumor was observed only in 1 patient. In 3 cases stenting was performed (palliative intervention in 2 patients and as preoperative stage in 1 case). Stomach probe for feeding was deployed in 1 observation. CONCLUSION: Patients after previous chemical burn of the esophagus and esophagoplasty should be under follow-up for timely diagnosis and treatment of esophageal malignancies.